The United States District Court for the Northern District of Georgia recently granted several defending healthcare insurers’ motions to compel arbitration and (in part) to dismiss claims alleging improper reimbursement practices brought under the Emergency Medical Treatment and Labor Act (“EMTALA”), Affordable Care Act (“ACA”), COBRA, and various Georgia state law theories. The order, styled Apollo MD Business Services v. Amerigroup Corporation (Delaware), No. 1:16-cv-4814, Dkt. 70 (N.D. Ga. Nov. 27, 2017), is available here.
The Court’s discussion of EMTALA is noteworthy, because after examining the statute, the Court held that the plaintiff, a healthcare staffing and billing company, did not have standing to pursue any claims under EMTALA. Although the Court’s treatment of EMTALA is relatively brief, the punchline of the opinion is broadly applicable:
There is no evidence that Congress intended for EMTALA to apply to issues arising from insurers’ reimbursement for care administered pursuant to the statute’s requirements. Nor is there any indication–in the text of the statute or otherwise–that an entity like Plaintiff has standing to bring a claim under EMTALA. To the contrary, EMTALA’s remedial mechanisms are quite plainly restricted to persons requiring emergency medical treatment and medical facilities that suffer financial loss as a result of a participating hospital’s violation of EMTALA.
Op. at 37-38 (emphasis original). Because plaintiff was “a company that staffs emergency departments and hospitals[,]”the Court concluded that it could not bring a claim under EMTALA as a matter of law. Id. at 38. Of interest, despite later acknowledging that medical facilities and “persons requiring emergency medical treatment” fall under “EMTALA’s remedial mechanisms,” the Court believed the defending healthcare insurers’ argument that “only hospitals are amenable to suit under that statue” was “correct.” Id. at 37 (emphasis added). While the contours of EMTALA remain subject to ongoing litigation, the Apollo decision emphasizes that the identity and characteristics of a plaintiff entity can become dispositive in lawsuits involving EMTALA claims.